Author, as appears in the article.: Montalvo, Itziar; Gonzalez-Rodriguez, Alexandre; Cabezas, Angel; Gutierrez-Zotes, Alfonso; Sole, Montse; Algora, Maria Jose; Ortega, Laura; Martorell, Lourdes; Sanchez-Gistau, Vanessa; Vilella, Elisabet; Labad, Javier;

Department: Infermeria

URV's Author/s: Martorell Bonet, Lourdes / Ortega Sanz, Laura

Keywords: Type-2 diabetes-mellitus Serum interleukin-6 Risk Insulin Impairment Glycated haemoglobin Glucose-tolerance Glucose Free-thyroxine levels Early psychosis Drug-naive patients Cortisol awakening response Cortisol Cognition 1st-episode schizophrenia glucose early psychosis cortisol cognition

Abstract: Background Glucose abnormalities and cognitive alterations are present before the onset of schizophrenia. We aimed to study whether glucose metabolism parameters are associated with cognitive functioning in recent-onset psychosis (ROP) patients while adjusting for hypothalamic-pituitary adrenal (HPA) axis measures. Methods Sixty ROP outpatients and 50 healthy subjects (HS) were studied. Cognitive function was assessed with the MATRICS Consensus Cognitive Battery. Glycated haemoglobin (HbA1(c)), glucose, insulin, and C-peptide levels were determined in plasma. The HOMA-insulin resistance index was calculated. Salivary samples were obtained at home on another day to assess the cortisol awakening response and cortisol levels during the day. Univariate analyses were conducted to explore the association between glucose metabolism parameters and cognitive tasks. For those parameters that were more clearly associated with the cognitive outcome, multiple linear regression analyses were conducted to adjust for covariates. Each cognitive task was considered the dependent variable. Covariates were age, sex, education level, diagnosis, antipsychotic and benzodiazepine treatment, body mass index (BMI), smoking, and HPA axis measures. Potential interactions between diagnosis and glucose parameters were tested. Results There were no significant differences in HPA axis measures or glucose parameters, with the exception of C-peptide (that was higher in ROP patients), between groups. ROP patients had a lower performance than HS in all cognitive tasks (p < 0.01 for all tasks). Of all glucose metabolism parameters, HbA1c levels were more clearly associated with cognitive impairment in cognitive tasks dealing with executive functions and visual memory in both ROP patients and HS. Multivariate analyses found a significant negative association between HbA1c and cognitive functioning in five cognitive tasks dealing with executive functions, visual memory and attention/vigilance (a ROP diagnosis by HbA1(c) negative interaction was found in this latter cognitive domain, suggesting that HBA1(c) levels are associated with impaired attention only in ROP patients). Conclusions Our study found that HbA1(c) was negatively associated with cognitive functioning in both ROP patients and HS in tasks dealing with executive functions and visual memory. In ROP patients, HbA1(c) was also associated with impaired attention. These results were independent of BMI and measures of HPA axis activity.

Thematic Areas: Psychiatry and mental health Psychiatry Psicología Medicina ii Medicina i Interdisciplinar Ensino Engenharias iv Educação física Ciências biológicas ii Ciências biológicas i Ciências ambientais Astronomia / física Administração pública e de empresas, ciências contábeis e turismo

ISSN: 16640640

Author's mail: lourdes.martorell@urv.cat laura.ortega@urv.cat

Author identifier: 0000-0003-4999-2197 0000-0003-2476-7700

Record's date: 2023-05-14

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00455/full

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Frontiers In Psychiatry. 11 (455): 455-

APA: Montalvo, Itziar; Gonzalez-Rodriguez, Alexandre; Cabezas, Angel; Gutierrez-Zotes, Alfonso; Sole, Montse; Algora, Maria Jose; Ortega, Laura; Martorell, (2020). Glycated Haemoglobin Is Associated With Poorer Cognitive Performance in Patients With Recent-Onset Psychosis. Frontiers In Psychiatry, 11(455), 455-. DOI: 10.3389/fpsyt.2020.00455

Article's DOI: 10.3389/fpsyt.2020.00455

Entity: Universitat Rovira i Virgili

Journal publication year: 2020

Publication Type: Journal Publications